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1013211846
CUSTOM DENTAL OF EDMOND, PLLC
OKLAHOMA CITY, OK
NPI
1013211846
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Entity Type
Organization
Authorized Contact
GRANT PITT
Dentist
405-282-6440
Organization Subpart ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: OK 5978)
Enumeration Date
2011-01-10
Last Update Date
2011-09-15
Business Address
CUSTOM DENTAL OF EDMOND, PLLC
17840 N. PENN
OKLAHOMA CITY, OK 73012
Phone number: 405-282-6440
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Mailing Address
CUSTOM DENTAL OF EDMOND, PLLC
17840 N PENNSYLVANIA AVE
EDMOND, OK 73012-9097
Phone number: 405-282-6440
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